Are all places like this?

[Dallas_bound_06]

I graduated from a practical nursing program in December, and started my first job in January at an LTC. I'm getting more and more frustrated and am thinking about changing jobs, but first I want to know if they're all like this.

I was told I'd get 2 weeks of training with another nurse. This translated into 7 days, one of which was on the shift and hall I was hired for, then I was on my own the next night. (There were other nurses in the building, but they were busy with their own jobs.)

"You'll get a uniform voucher after 90 days." I've been there 6 months and haven't seen it yet -- some have been waiting even longer.

The main problems, though, are scheduling and supplies.

The schedule is supposed to be posted 3 weeks in advance. Normally we get the next week's schedule on Wednesday or Thursday, rarely do we see 3 weeks at a time. This week's schedule was the worst -- it went up yesterday (Tuesday) and next week's is posted, but that's it. (The person who does our scheduling was on vacation last week and didn't get the schedules posted before she left.)

I'd requested vacation for next week (turned the form in months ago -- turned it in twice, in fact). Last week the DoN said I was off so I went ahead and scheduled my boards. Yesterday the schedule went up and I'm working the day before boards (3:30 to midnight with boards over an hour away at 8:00 am.) So now I'm rescheduling my boards.

And supplies. The same person who does the scheduling orders the supplies. While she was gone we almost ran out of several items, including chucks and souffle cups.

Even when she's not on vacation, finding a bottle of normal saline (we have some residents who are supposed to have their g-tubes flushed with it) often involves a hunt through 5 or 6 different places (often coming up empty).

Distilled water for the c-paps, bi-paps and oxygen concentrators? Most times when I need it I have to go get it from the hall that has the ventilators, and hope they have some to spare.

One day we were out of insulin syringes (none anywhere in the building; we were using tb syringes to give insulin).

(Side note: As I was typing this the DoN called me and asked me to work a double tomorrow -- get home at 12:30 am, be back at 7:30am until midnight. I agreed to do it, but only if I could leave early tonight so I could sleep.)

(The DoN is new to the facility and is trying to solve the scheduling issue, is very easy to talk to and work with, and I don't blame her for the problems at all.)

Are these problems common? In other words, will leaving here for another facility just land me in a different pile of the same crap?

Thanks in advance... (and sorry for the length).

[Luv2BAnurse]

No, not all, but some.

But that doesn't mean you have to work there. If it is something you can tolerate, stay a while to see if the new DON can facilitate changes. How long has she been there anyway? Change does take time, but just remember your sanity in the meantime.

[banditrn]

Dallas - I'm fairly new to LTC, but have been a nurse for a long time. Some of the things you mention are a problem where I work, too.

We run out of gloves, alcohol swabs, wash cloths, you name it!! I'm getting very tired of working OT, just to get everything done - I work at nite, and they will only allow 1 aide for 40 patients, so I spend a lot of time doing aide work. We have a lot of patients who are on the lite a lot at nite, and it's too much for one person! I complained to the DON - she just told me to tell the aide that SHE would have to answer all the lites!! I wish I could get her in there to work a few shifts to see what it's really like. Both of us are run ragged.

I personally think that 'double-shifts' ought to be illegal.

[mtngrl, ASN, RN]

Sounds like you need a new job.

[Natkat, BSN, MSN, RN]

I agree, it's not everywhere but yeah it happens.

We run out of supplies a lot where I work. We aren't always out, but it happens more often than I'd like. We can go weeks without something, then we'll have it, but then run out of something else for weeks.

Oh and scheduling! Our boss only does our schedule for two weeks at a time. And when it's time for the new schedule to go up, it's not unheard of for us to not know until Sunday night if we're working Monday morning.

I stick around because I love my boss. She's so easy to work with that I put up with it. It's the less of two evils.

But yeah, someone needs to have a talk with the scheduling/supply person. Maybe she doesn't understand how her lack of preparedness affects you all. Or maybe she doesn't care, in which case then there's nothing you can do.

I would look for something else, but keep in mind it could get worse someplace else!!! So leave on good terms in case you decide to come back.

[MrsMommaRN]

you need to bring up your concerns with your don you shouldn't have to r/s your boards. you would hope the facility would be accomidating in that matter.

not all ltc facilities are like this there are some really wonderful places, most of them though have some kind of issue going on. if you truly are not happy look for something else. that is the wonderful thing about nursing you can go anywhere.

[santhony44, MSN, RN, NP]

Nope, they're not all like that, and that's ridiculous.

Schedule only two weeks at a time?? You gotta be kidding me. I've never, never, ever run into that on any job. That's unreasonable.

The new DON needs to sit down and do the schedule herself and make it for four weeks minimum, six preferable. People need to plan their lives, for goodness' sake! Then she needs to get hold of the supply order forms and do that herself, too. Then the supply/schedule person who doesn't seem to have a clue should be told that this is the way it's going to be.

While I understand not wanting to over-order supplies, neither should running out of basic stuff be tolerated.

Being scheduled to work when I'd requested off for boards would've pushed me right on out that door!!

[indigo girl]

NO!!! They are not all like that. I have worked in many, many LTC's as staff and as an agency nurse. Look around, and you are bound to find a better place. Some places run by corporations, are so tight with their money that it's almost impossible to find the supplies you need to do your every day work. Staff is scouring the building every shift, and making do with what should already be on hand for them to take care of the patients. Other places, smaller sometimes, or family run, are tight in other ways, but you have the basic supplies, and they manage staff better, and pay attention to more details. Look in the newspaper. Places that are always advertising for staff usually means they have problems with retaining them for good reasons. Ask around especially to agency nurses. Where do they like to work? Get as much info as you can, and ask to talk to staff in other places you are thinking of working in when you interview. In short, go somewhere else, your facility is not meeting your needs and probably not the patients either if you consistently are out of supplies (from experience, that's a sign of other bigger problems).

[meownsmile, BSN, RN]

First, i wouldnt let a job interfere with taking your boards. Call in sick the night before if you have to but you need the evening to relax, get a good nights sleep and be fresh for the test the next morning. If they dont understand that,, then they dont need you that bad.

Most places will give you the day before your test off and the day of the test off with pay if you were scheduled to work that day.

Dont let them mess it up for you. I surely wouldnt have rescheduled my test,, they would have been reworking their schedule.

[LoriAlabamaRN]

They are DEFINITELY not all like that, but I feel your pain. The last place I worked was an IP physical rehab place. I worked 11-7, and we always ran out of EVERYTHING. One night I came in at 11 to find there were no pads or diapers in the building because they had "run out." I called the DON at home, she had the NERVE to tell me to put garbage bags under the incontinent patients!!! Fortunately, I came to my senses and found another job as quick as I could. I love the place I work now, and I would not change it for the world.

Don't stay in a job you hate- it really isn't worth it.

[elcue]

quote=

side note: as i was typing this the don called me and asked me to work a double tomorrow -- get home at 12:30 am, be back at 7:30am until midnight. i agreed to do it, but only if i could leave early tonight so i could sleep.)

here's one thing this old nurse would like to pass on to you as you begin your career: learn to say "no, i'm sorry, i can't help you this time." it is ok to say no! we nurses tend to think we can't say no, but we certainly can and sometimes it is the responsible thing to do. please, begin your career by refusing to accept the guilt that some administrators, unfortunately, count on when they expect individual nurses to solve the problems of an institution.

agreeing to work those crazy hours, regardless of your age, is dangerous to yourself and your patients. what kind of shape are you in by the time you're driving home the 2nd day?

what is the risk of a patient-care error during a 16-hour shift after little sleep the night before? if they don't send you home early the first day, (and don't count on it - what if someone else calls in sick?), you will be working 24 out of 32 consecutive hours. here's a guideline: would you want a nurse in that exhausted condition to care for your mother?

please, please take care of yourself. and good luck on your boards.

linda